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Reasons You're Not Losing Weight After Gastric Sleeve Surgery

10 Reasons and Effective Strategies to Overcome Weight Loss Plateaus After Gastric Sleeve Surgery


You have undergone gastric sleeve surgery with the intention of helping you lose weight effectively, but you’re disappointed at the result as your weight seems to be stubbornly clinging on. 

You may question why, despite following what you thought was the right path, the pounds aren’t melting away as expected. 

Therefore, understanding why you’re not seeing the results you hoped for is important to adjust your strategy and continue on your journey to weight lose.

1. You Have Reached a Plateau

It’s quite common to hit a weight loss plateau after bariatric surgery. Initially, you may notice a significant drop in pounds due to the reduced food intake and changes in your metabolism. However, your body is adaptable and eventually adjusts to these changes.

A plateau occurs when your metabolism slows down as you lose weight, leading to a decrease in the number of calories you burn daily. This is a natural response as your body becomes more efficient in its energy expenditure. Understand that plateaus are a normal part of the weight loss process and can last for several weeks.

When you hit this plateau, you need to evaluate your lifestyle and dietary habits. Consider tweaking your diet to reduce calories further or increase your physical activity. 

Sticking to your bariatric team’s recommended plan, while frustrating at times, is vital during a plateau. As you can understand, consistency is key to move past this phase.

2. Caloric Intake Is Too High

Even though gastric sleeve surgery reduces the capacity of your stomach, it’s still possible to consume too many calories, which can impede weight loss. 

High-calorie foods, especially those rich in sugars and fats, can easily fit into your smaller stomach and contribute to a calorie surplus.

Here’s how excess calorie intake can affect your progress:

  • Snacking: Mindless or frequent snacking on high-calorie foods can add up throughout the day.
  • Liquid Calories: Drinks like soda, juice, or creamy coffee can be deceiving; they’re often high in calories and don’t make you feel full.
  • Portion Sizes: Even with a smaller stomach, eating portions that are too large for your current needs can lead you to overeat.
  • Dense Foods: You might gravitate towards calorie-dense foods that your reduced stomach can still accommodate.

To tackle this, keep a food diary to become more aware of what you’re consuming. Measure portions, count calories, and most importantly, stick to nutrient-dense foods that will help you stay full on fewer calories. 

Lean proteins, vegetables, and whole grains should be the cornerstone of your diet. Consulting a dietitian who specializes in post-bariatric surgery can help you create a meal plan that suits your new dietary needs.

Emotional eating after bariatric surgery can also be a significant roadblock to weight loss. Turning to food for comfort, stress relief, or as a reward can derail your diet, often leading to the consumption of unhealthy, high-calorie foods. So you need to understand what triggers your emotional eating and develop strategies to deal with those emotions without food.

3. Poor Meal Timing and Frequency

The timing and frequency of your meals can also have an impact on your weight loss. Skipping meals or waiting too long between eating can lead to overeating later in the day.

Consider these strategies:

  • Consistent Meal Times: Try to eat at the same times every day to regulate your hunger and improve metabolism.
  • Smaller, Frequent Meals: Given your smaller stomach, eating smaller meals and snacks throughout the day can prevent extreme hunger and provide constant energy.

4. Lack of Exercise

Regular physical activity post-gastric sleeve surgery is critical for ongoing weight loss and overall health. Exercise helps to burn calories, increase metabolism, and even improve your mood, which can be a great motivator.

You can do some exercises like:

  • Not Enough Cardio: Cardiovascular activities like walking, swimming, or cycling are great for burning calories and improving heart health.
  • Neglecting Strength Training: Building muscle through resistance or weight training is crucial because muscle burns more calories at rest than fat.
  • Inconsistency: Sporadic workouts won’t yield the same results as a consistent exercise routine.

Start your exercise routine slowly and try to do activities like brisk walking for at least 150 minutes a week. Also, do exercises that strengthen your muscles on two or more days each week.

5. Hormonal Imbalances

Sometimes, the explanation for weight loss resistance lies within your hormonal balances. Conditions such as hypothyroidism can slow your metabolism and make weight loss more challenging. 

Issues with insulin resistance and even fluctuations in sex hormones can also play a significant role in your ability to lose weight after surgery.

If you suspect a hormonal imbalance, you need to consult your doctor. A healthcare professional can order tests to check your hormone levels and determine if an imbalance is affecting your weight.

6. Medication Side Effects

Certain medications can contribute to weight gain or make it hard to lose weight. Some common prescriptions that may impact your weight include corticosteroids, antidepressants, and antipsychotic drugs.

Ask your doctor about any side effects of any medications you are taking. There might be alternative medications available that do not affect your weight as profoundly. 

7. Insufficient Sleep

Good sleep is important for weight loss but often ignored. It affects hormones that control hunger, such as ghrelin and leptin. Not sleeping enough can make you hungrier and more prone to eat too much.

  • Prioritize Sleep Hygiene: Create a restful environment, maintain regular sleep hours, and avoid screens before bedtime to improve your sleep quality.
  • Manage Stress: High stress can affect your ability to sleep and prompt comfort eating. Practice relaxation techniques such as meditation or deep breathing exercises.

8. Nutritional Deficiencies

In the post-operative diet phase, your reduced food intake can lead to deficiencies in essential vitamins and minerals, affecting your metabolism and overall health. Deficiencies can make you feel fatigued or unwell, reducing your ability to stay active and stick with your weight loss plan.

Here’s how you can address nutritional deficiencies:

  • Supplemental Support: Your doctor will likely recommend supplements to prevent deficiencies, especially for iron, calcium, vitamin B12, folate, and vitamin D.
  • Regular Blood Tests: Periodic monitoring can help you stay on top of your nutritional status and adjust your supplementation as needed.
  • Nutrient-rich Foods: Focus on incorporating a variety of nutrient-dense foods into your meals to cover a wider range of vitamins and minerals.

9. Inadequate Protein Intake

Protein is essential after gastric sleeve surgery because it helps to aid in the healing process, maintain muscle mass, and promote satiety. If you’re not eating enough protein, you may feel hungrier and more tempted to eat unhealthy foods.

To avoid protein deficiency:

  • Protein First: Make protein-rich foods the first thing you eat at meals to ensure you get enough before feeling full.
  • High-Quality Proteins: Include lean meats, beans, legumes, and low-fat dairy products in your diet to meet your protein requirements.
  • Protein Supplements: Consider protein shakes or bars as a convenient way to boost your intake, especially when solid food intake is challenging.

10. Less Post-Surgery Support

Support from healthcare providers, family, and peer groups can be pivotal in your weight loss journey. Regular follow-up visits with your bariatric team help monitor your progress and can catch potential issues early.

Many bariatric centers offer support groups for post-operative patients. Participating in these can provide encouragement and useful tips from peers.

Meanwhile, Stay informed about the best practices for post-bariatric surgery lifestyle through workshops, counseling, or reading material.


There are a variety of factors that could be impeding your weight loss after gastric sleeve surgery. It’s important to understand that weight loss will not be immediate and requires a combination of diet, exercise, and lifestyle changes.

Be honest with yourself about following your post-surgery plan, and don’t hesitate to reach out for help from your healthcare provider or support groups.

With dedication and patience, you can overcome these hurdles and continue making progress towards your weight loss goals.

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